Financial Data and Key Metrics Changes - Adjusted operating income for Q2 2025 was $551 million, and adjusted earnings per share were $2.95, with free cash flow at $157 million [16][15] - The company reaffirmed its guidance for adjusted operating income between $2.01 billion and $2.16 billion and adjusted earnings per share between $10.20 and $11.30 for the full year [14][15] Business Line Data and Key Metrics Changes - US treatments per day declined by 1.1% year-over-year, primarily due to a higher than expected mistreatment rate, which was influenced by the cyber incident [17][30] - Revenue per treatment (RPT) increased by approximately $4.5 compared to Q1, but was negatively impacted by the cyber incident and lower dispensing volumes of binders [18][19] - Patient care costs per treatment decreased by approximately $3.5 sequentially, attributed to higher treatment counts, improved labor productivity, and lower binder dispensing volumes [20][21] Market Data and Key Metrics Changes - The company anticipates a year-over-year decline in treatment volume of 75 to 100 basis points, revised from a previous estimate of down 50 basis points [17][18] - International adjusted operating income increased by $6 million compared to Q1, primarily due to a one-time benefit [21] Company Strategy and Development Direction - The company is focused on clinical innovation and improving patient outcomes through advanced technologies and pharmaceuticals, including new drug classes and next-generation devices [6][7] - The company is committed to maintaining operational excellence and cost control, which is expected to continue even as treatment volumes normalize [76][77] Management's Comments on Operating Environment and Future Outlook - Management expressed optimism about entering a new wave of clinical innovation that could improve patient care and outcomes [6][7] - The company acknowledged the ongoing impact of the cyber incident but believes that the effects on adjusted results will be limited moving forward [11][30] Other Important Information - The company repurchased 3.1 million shares during Q2 and an additional 2.7 million shares since the end of the quarter [23] - The company raised $1 billion in senior unsecured debt and repriced its term loan, reducing the spread by 25 basis points [23] Q&A Session Summary Question: How did census and treatments track following the cyber attack? - Management indicated that while there were initial challenges, operations have normalized since the incident, but mistreatment rates spiked unexpectedly [30][31] Question: Can you provide phosphate binder contribution to RPT and CPT in the quarter? - The RPT contribution was in the low eights, and CPT was in the high sixes, with lower dispensing volumes attributed to adherence issues rather than a mix problem [34][35] Question: How is the company maintaining guidance despite treatment growth challenges? - The company is managing costs effectively, particularly in labor, and has seen better-than-expected performance in international operations [41][42] Question: What is the reason for the elevated mortality rates? - Management believes the elevated mortality is a holdover from COVID, with delays in care and sicker patients contributing to the trend [71][72] Question: What is the expected impact of new technologies on patient care? - The company is actively monitoring and conducting studies on new technologies, with a focus on improving patient outcomes through better clearance of middle-sized molecules [90][91]

Financial Data and Key Metrics Changes - The company achieved strong organic revenue growth of 7% in Q2 2025, with a 5% increase at constant currency [6][18] - Operating income grew by 13% on a constant currency basis, leading to a margin expansion to 9.9% [18][20] - Operating cash flow increased by 75%, and the net leverage ratio improved to 2.7 times, within the target range of 2.5 to 3 times [7][28] Business Line Data and Key Metrics Changes - Care Delivery in the U.S. showed organic growth of 3.4%, supported by favorable rate and payer mix, despite volume impacts from a severe flu season [22] - Internationally, Care Delivery achieved robust organic growth of 4.5%, driven by 1.7% same market treatment growth [23] - Value Based Care segment realized a strong organic revenue growth of 28%, primarily due to increased member months from expanded contracting [25] - Care Enablement reported a 3% revenue growth, with a significant 79% increase in operating income, leading to a margin increase of 380 basis points [26] Market Data and Key Metrics Changes - In the U.S., patient inflow dynamics improved, with five consecutive months of increasing referrals and new patient starts [15][46] - The severe flu season earlier in the year resulted in elevated mortality and mistreatments, impacting overall patient flow [16][60] Company Strategy and Development Direction - The company is focused on the "FME Reignite" strategy to enhance kidney care through exceptional patient care and innovation [5] - A share buyback program of €1 billion was announced, aimed at returning excess cash to shareholders [7][29] - The company is refining its operating model by separating Value Based Care as a distinct reporting segment to enhance financial transparency [12] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in achieving accelerating earnings development in the second half of 2025, despite current volume challenges [30][75] - The company expects to confirm its full-year outlook, projecting operating income growth in the high teens to high 20s percent range compared to the prior year [31][32] Other Important Information - The company plans to launch the 5,000 MADE X and high volume HDR in the U.S. clinics, with a rollout beginning in Q3 [11] - The impact of foreign exchange rates was noted, with a potential 3% to 4% headwind on revenue and earnings if current rates persist [106] Q&A Session Summary Question: U.S. Volume Growth and 2026 Outlook - Management indicated that while current mortality rates are elevated, they expect to see growth in U.S. volumes in 2026, supported by improving referral trends [38][40] Question: Care Enablement Margin Expansion - Management expressed optimism about continued margin expansion in Care Enablement, particularly in the second half of the year, which is typically stronger [41] Question: Patient Inflow Dynamics - Management noted that patient inflows have improved significantly, with the best trends seen in years, and emphasized the importance of both market conditions and internal processes [46][47] Question: Value Based Care Revenue Growth - Management confirmed strong revenue growth in Value Based Care, with expectations for continued strength in the second half, although operating income is expected to remain slightly negative to breakeven [52][56] Question: Phosphate Binders Contribution - Management indicated that phosphate binders contributed positively in H1, with expectations for continued support in the second half, although specific contributions were not quantified [67][82] Question: High Volume HDF Machine Rollout - The company is on track to convert 30 clinics and 600 machines during Q3 and Q4, with significant financial impacts expected in 2026 [103] Question: FX Headwind on EBIT - Management expects a 3% to 4% impact on both revenue and earnings from foreign exchange rates if current levels persist [106]

Analyst Presentation Helen Giza CEO & Chair of the Management Board Martin Fischer CFO August 5, 2025 Q2 2025 IR Conference Call Safe harbor statement: In this Safe harbor statement, "the Company" and "Fresenius Medical Care" refer to Fresenius Medical Care AG & Co. KGaA, a German partnership limited by shares, prior to its conversion of legal form, and to Fresenius Medical Care AG, a German stock corporation, after its conversion of legal form. This presentation includes certain forward-looking statements ...

Financial Data and Key Metrics Changes - First quarter adjusted operating income was $439 million, adjusted EPS was $2, and free cash flow was negative $45 million, with adjusted operating income above guidance due to strong expense management and international performance [18][25] - Revenue per treatment increased by $4, with approximately $10 attributed to new reimbursement for phosphate binders, partially offset by a $5 decline due to seasonal patient responsibility [21][40] - Patient care cost per treatment increased by $7 sequentially, driven by new costs associated with phosphate binders [21] Business Line Data and Key Metrics Changes - Adjusted international operating income increased by $29 million compared to the previous quarter, with a strong performance across various markets [22] - Integrated Kidney Care (IKC) reported operating losses of $29 million, in line with expectations, with seasonally stronger performance anticipated in the second half of the year [22] Market Data and Key Metrics Changes - Treatments per day declined by 40 basis points year-over-year and were approximately 50 basis points below forecast, primarily due to a higher missed treatment rate from a severe flu season [19] - The company expects an approximately 50 basis point decline in treatments for the year, influenced by flu-related impacts and the cyber incident [20] Company Strategy and Development Direction - The company remains committed to investing available capital in innovation and high-return growth opportunities, including a recent acquisition in Latin America [13] - The capital allocation strategy includes returning capital to shareholders through share repurchases, with approximately $680 million repurchased since the last earnings call [13] Management's Comments on Operating Environment and Future Outlook - Management highlighted the resilience of operations despite a cybersecurity incident that disrupted parts of the business, with uninterrupted patient care maintained [9][10] - The company reiterated its 2025 guidance range for adjusted operating income and adjusted EPS, despite headwinds from the cyber incident and a challenging flu season [16][25] Other Important Information - The company launched a community-based collaboration with the YMCA to support chronic kidney disease education and prevention, with early results showing 30% of participants screened had previously undiagnosed CKD [6][7] - The company is addressing regulatory and legal follow-ups related to the cyber incident, with most costs expected to be one-time items recognized in the second quarter [10][31] Q&A Session Summary Question: Impact of flu and cyber attack on treatment volume - The flu had a significant impact on the full year treatment volume, accounting for more than half of the 50 basis point revision, while the cyber incident contributed to a loss of approximately 500 admissions [29][30] Question: Costs related to the cyber attack - Majority of costs from the cyber attack will be one-time items recognized in Q2, with some direct costs likely covered by insurance and not included in adjusted operating income [31] Question: Phosphate binders uptake and drug mix - The mix leaned towards iron-based binders, leading to an increase in guidance for operating income contribution from phosphate binders to the upper end of the previous range [32][33] Question: Revenue per treatment expectations - Revenue per treatment is expected to remain within the previously guided range of 4.5% to 5.5%, with half of the increase coming from core business and half from orals [43][44] Question: International market performance - International operations had a strong quarter, with a significant year-over-year increase, and the company feels positive about the new acquisition's performance [58]

Financial Data and Key Metrics Changes - First quarter adjusted operating income was $439 million, adjusted EPS was $2, and free cash flow was negative $45 million, with adjusted operating income above previous guidance due to strong expense management and international performance [18][25] - Revenue per treatment increased by $4, with approximately $10 attributed to new reimbursement for phosphate binders, partially offset by a $5 decline due to seasonal patient responsibility [21][39] - Patient care cost per treatment increased by $7 sequentially, driven by approximately $8 per treatment of new costs associated with phosphate binders [21] Business Line Data and Key Metrics Changes - Adjusted international operating income increased by $29 million compared to the fourth quarter, with strong performance across various markets [22] - Integrated Kidney Care (IKC) reported operating losses of $29 million, in line with expectations, with seasonally stronger performance anticipated in the second half of the year [22] Market Data and Key Metrics Changes - Treatments per day declined by 40 basis points compared to Q1 2024, primarily due to a higher missed treatment rate caused by a severe flu season [19] - The company expects an approximately 50 basis point decline in treatments for the year, influenced by flu-related impacts and a cyber incident [20] Company Strategy and Development Direction - The company remains committed to investing available capital in innovation and high-return growth opportunities, including a recent acquisition in Latin America [13] - The capital allocation strategy includes returning capital to shareholders through share repurchases, with approximately $680 million repurchased since the last earnings call [13] Management's Comments on Operating Environment and Future Outlook - Management highlighted the resilience of operations despite a cybersecurity incident that disrupted parts of the business, with uninterrupted patient care maintained [9][10] - The company reiterated its 2025 guidance range for adjusted operating income and adjusted EPS, despite headwinds from the cyber incident and a challenging flu season [16][25] Other Important Information - The company launched a community-based collaboration with the YMCA to support chronic kidney disease education and prevention, with early results showing 30% of participants screened had previously undiagnosed CKD [6][7] - The majority of costs related to the cyber incident are expected to be one-time items recognized in the second quarter [31] Q&A Session Summary Question: Impact of flu and cyber attack on treatment growth - Management indicated that the flu had a more significant impact on the full year guidance, with the census decline in Q1 affecting the full year [29] Question: Costs related to the cyber attack - Management clarified that some costs will be direct and non-GAAP, likely covered by insurance, while others will flow through the P&L and are included in guidance [31] Question: Phosphate binders uptake and drug mix - The mix leaned towards iron-based binders, leading to an adjustment in guidance to the upper end of the previous range [33] Question: Revenue per treatment and managed care increases - Management confirmed that revenue per treatment guidance remains unchanged, with increases expected from both core business and oral medications [42] Question: IKC patient treatment and competitive pricing - Management noted that the financials are playing out as expected, with a disciplined approach to patient care and financial modeling despite competitive pressures [51] Question: International performance outlook - International operations had a strong quarter, with positive contributions from various markets and a successful acquisition [57]